Information Collection

0012 Reinstatement to practice

IC 203101 under ICR 201301-0651-003 · OMB 0651-0072.

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IC Title:	0012 Reinstatement to practice	Agency IC Tracking Number:	9004

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 37 CFR 1.21(a)(9)(ii)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Economic Development

Subfunction: Intellectual Property Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22	-398	420
Annual IC Time Burden (Hours)	0	0	0
Annual IC Cost Burden (Dollars)	2,200	-39,800	42,000

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